Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Mindy Baccam Southammavong, PA-C

Individual provider Medical Physician Assistant · NPI 1528434859

Mindy Baccam Southammavong, PA-C is a Physician Assistant in Pella, Iowa. Qualified in 2015, 11 years ago. Practices with Iowa Physicians Clinic Medical Foundation, a 1,242-clinician group and accepts Medicare assignment. Licensed in Iowa.

Years since qualifying
11
Licensed in
IA
In the registry since
2015
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

405 Monroe St
Pella, IA 50219-1189
Phone: (641) 621-2200
Fax: (641) 621-2335
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 078982 (IA)

Record details

NPI number1528434859
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 20, 2015
Last updated in NPPESMay 1, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Iowa Physicians Clinic Medical Foundation — 1242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Iowa Physicians Clinic Medical Foundation

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 1242 clinicians in the practice; 12 are shown here.

Other providers in Pella